Individual
DAWN MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1869
MN
225100000X
Physical Therapist
Primary
5635
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15D94MO
BCBS
MN
05
—
41810700
—
WI
01
—
6411503
MEDICA
MN
01
—
HP25224
HEALTH PARTNERS
MN
Enumeration date
09/28/2006
Last updated
07/09/2007
Update your record
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